Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Ritalin, Ritalin SR, Ritalin LA, Concerta, Methylin, Methylin ER,
Metadate CD, Metadate ER
DRUG CLASS AND MECHANISM: Methylphenidate is a medication that stimulates the
central nervous system (CNS or brain) in a manner that is similar to the
amphetamines; however, its actions are milder than those of the amphetamines. An
additional difference is that methylphenidate produces more noticeable effects
on mental activities than on motor activities. Methylphenidate and amphetamines
both have abuse potential. In treating children with attention-deficit
hyperactivity disorder (ADHD), methylphenidate produces a calming effect. This
results in a reduction in hyperactivity and an improvement in attention span.
Methylphenidate also is used to treat excessive sleepiness. Methylphenidate was
approved by the FDA in 1955.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS:
Tablets: 5, 10, and 20 mg (Ritalin);
Sustained-release tablets
(Ritalin SR): 20 mg;
Long acting tablets (Ritalin LA): 20, 30, and 40 mg.
Extended release tablets (Concerta): 18, 27, 36, and 54 mg.
Chewable tablets
(Methylin): 2.5, 5, and 10 mg;
Solution (Methylin): 5 mg/5 ml, 10 mg/5 ml.
Extended release tablets (Methylin ER, Metadate ER): 10, 20 mg.
STORAGE: Tablets should be kept at room temperature, 15- 30 C (59-86 F).
PRESCRIBED FOR: Methylphenidate is used in the treatment of narcolepsy
(uncontrollable sleepiness) and children with ADHD.
DOSING: The dose of methylphenidate is adjusted based on patients' responses.
It may be given once, twice, or three times daily depending on formulation. The
recommended dose for Concerta is 18-72 mg once daily. The recommended dose for
Ritalin LA is 10-60 mg once daily and for regular Ritalin the recommended dose
is 10-60 mg daily in 2 or 3 divided doses.
DRUG INTERACTIONS: The stimulation effects of methylphenidate on the CNS can
be additive when used with other chemicals and medications that stimulate the
CNS, such as caffeine (found in coffee, tea, or cola drinks), and
pseudoephedrine or phenylpropanolamine (found in many cough-and-cold
preparations). The combination of methylphenidate and monoamine oxidase
inhibitors (MAOIs), for example, isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate), and procarbazine (Matulane), should not be taken with
methylphenidate since a hypertensive crisis (severely high blood pressure) may
occur. Moreover, methylphenidate should not be given to any patient within 14
days of receiving such an inhibitor. The blood pressure lowering effects of
medications used to treat hypertension may be reduced by methylphenidate. As a
result, blood pressure needs to be monitored when starting or stopping
methylphenidate in patients who are receiving medications for controlling their
blood pressure.
PREGNANCY: There are no adequate studies of methylphenidate in
pregnant
women.
NURSING MOTHERS: It is not known if methylphenidate is secreted in
breast
milk.
SIDE EFFECTS: The most common side effects with methylphenidate are
nervousness, agitation, anxiety, and insomnia. Insomnia can be limited by taking
the drug before noon. For children taking methylphenidate for ADHD, the most
common side effects are loss of appetite, abdominal pain, weight loss, and sleep
problems. The rate and severity of these side effects are less than that seen
with dextroamphetamine (Dexedrine). Other side effects include nausea, vomiting,
dizziness, palpitations, headache, involuntary movements, chest pain, increased
heart rate, increased blood pressure, and psychosis. There have been rare
reports of Tourette's syndrome, a syndrome in which there are uncontrollable
tics such as grimacing. Because of the potential for side effects,
methylphenidate should be used with caution by patients who have relatives with Tourette's syndrome or have the syndrome themselves or who have severe anxiety,
seizures, psychosis, emotional instability,
major depression, glaucoma, or motor
tics. Sudden discontinuation of long-term methylphenidate therapy may unmask
depression. Gradual withdrawal, under supervision, is recommended.
Methylphenidate is habit forming and should be used cautiously in individuals
with a history of drug or alcohol abuse. Chronic abuse can lead to tolerance and
psychological dependence leading to abnormal behavior.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep and overeating.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Narcolepsy, a chronic disease of the central nervous system causes have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, disturbed nocturnal sleep, and automatic behavior. Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
Kleine-Levin syndrome is a rare sleep condition, primarily affecting adolescent males. Symptoms of Kleine-Levin syndrome include recurring but reversible periods "episodes" of excessive sleep. There is no definitive treatment for Kleine-Levin syndrome. Medication can be prescribed to treat sleepiness and episodes.
Seasonal affective disorder (SAD) is a type of depression that tends to occur (and recur) as
the days grow shorter in the fall and winter. It is believed that affected
people react adversely to the decreasing amounts of sunlight and the
colder temperatures as the fall and winter progress. It is important to note that although seasonal affective disorder usually presents in the fall and winter there are those who suffer from this condition during the summer instead of, or in addition to, during the fall or winter.
Seasonal affective disorder has not been long recognized as an official
diagnosis. The term first appeared in print in 1985. Seasonal
affective disorder is also sometimes called winter depression, winter blues, or the
hibernation reaction.
The incidence of seasonal affective disorder increases in people who are living farther away
from the equator. Statistics on seasonal affective disorder in ...
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